Medical termination of a partial hydatidiform mole and coexisting fetus during the second trimester: A case report

Wang,Yinfeng; Qian,Honglang; Wang,Jinhua

doi:10.3892/ol.2015.3743

Medical termination of a partial hydatidiform mole and coexisting fetus during the second trimester: A case report

Authors:
- Yinfeng Wang
- Honglang Qian
- Jinhua Wang
View Affiliations

Affiliations: Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China, Department of Radiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
Published online on: September 24, 2015 https://doi.org/10.3892/ol.2015.3743
Pages: 3625-3628

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Partial hydatidiform mole and coexisting fetus (PHMCF) is a rare condition that presents a dilemma for physicians and the parents of the fetus, particularly when PHMCF is detected during the second trimester of pregnancy. The present study reports a case of PHMCF terminated by induction of labor via administration of Rivanol at 17 weeks. Follow‑up measurements of serum β‑human chorionic gonadotropin (β‑HCG) levels, as well as imaging studies, indicated the presence of persistent trophoblastic disease (PTD) and lung metastases. The patient was therefore admitted for three courses of chemotherapy. Subsequently, the metastases receded and β‑HCG levels decreased to within the normal range. The patient demonstrated no disease recurrence for 1 year. Following a review of the relevant literature, to the best of our knowledge, all PHMCF cases terminated by medical induction of labor during the second trimester resulted in the development of PTD and lung metastases. However, three cases of PHMCF that were terminated by caesarean section during the third trimester did not develop PTD or metastases. The present study therefore hypothesized that medical termination may not be a safe therapeutic strategy for the treatment of PHMCF during the second trimester, and that pregnancy should be allowed to continue empirically.

View Figures

View References

1	Jones WB and Lauersen NH: Hydatidiform mole with coexistent fetus. Am J Obstet Gynecol. 122:267–272. 1975.PubMed/NCBI
2	Steller MA, Genest DR, Bernstein MR, et al: Natural history of twin pregnancy with complete hydatidiform mole and coexisting fetus. Obstet Gynecol. 83:35–42. 1994.PubMed/NCBI
3	Sebire NJ, Foskett M, Paradinas FJ, et al: Outcome of twin pregnancies with complete hydatidiform mole and healthy co-twin. Lancet. 359:2165–2166. 2002. View Article : Google Scholar : PubMed/NCBI
4	Peng M, Li L, Zheng J, Ding Y, Yu L and Huang J: Termination of twin pregnancies with hydatidiform moles: A case series of four patients. Iran J Public Health. 43:1000–1006. 2014.PubMed/NCBI
5	Niemann I, Sunde L and Petersen LK: Evaluation of the risk of persistent trophoblastic disease after twin pregnancy with diploid hydatidiform mole and coexisting normal fetus. Am J Obstet Gynecol. 197:45.e1–45.e5. 2007. View Article : Google Scholar
6	Worley MJ Jr, Joseph NT, Berkowitz RS and Goldstein DP: Women with a partial mole during their first pregnancy and diagnosed earlier in gestation are at increased risk of developing gestational trophoblastic neoplasia. Int J Gynecol Cancer. 24:941–945. 2014. View Article : Google Scholar : PubMed/NCBI
7	Tidy JA, Gillespie AM, Bright N, Radstone CR, Coleman RE and Hancock BW: Gestational trophoblastic disease: A study of mode of evacuation and subsequent need for treatment with chemotherapy. Gynecol Oncol. 78:309–312. 2000. View Article : Google Scholar : PubMed/NCBI
8	Tay ET: Partial hydatidiform mole and coexisting viable twin pregnancy. Pediatr Emerg Care. 29:1298–1300. 2013.PubMed/NCBI
9	Kim CH, Kim YH, Kim JW, Kim KM, Cho MK, Kim SM, Nam JH and Song TB: Triplet pregnancy with partial hydatidiform mole coexisting with two fetuses: A case report. J Obstet Gynaecol Res. 34:641–644. 2008. View Article : Google Scholar : PubMed/NCBI
10	Zhou X, Chen Y, Li Y and Duan Z: Partial hydatidiform mole progression into invasive mole with lung metastasis following in vitro fertilization. Oncol Lett. 3:659–661. 2012.PubMed/NCBI
11	Copeland JW and Stanek J: Dizygotic twin pregnancy with a normal fetus and a nodular embryo associated with a partial hydatidiform mole. Pediatr Dev Pathol. 13:476–480. 2010. View Article : Google Scholar : PubMed/NCBI
12	Sun CJ, Zhao YP, Yu S, Fan L, Wu QQ, Li GH and Zhang WY: Twin pregnancy and partial hydatidiform mole following in vitro fertilization and embryos transfer: A novel case of placental mosaicism. Chin Med J (Engl). 125:4517–4519. 2012.PubMed/NCBI
13	Vimercati A, de Gennaro AC, Cobuzzi I, Grasso S, Abruzzese M, Fascilla FD, Cormio G and Selvaggi L: Two cases of complete hydatidiform mole and coexistent live fetus. J Prenat Med. 7:1–4. 2013.PubMed/NCBI
14	Ingec M, Borekci B, Altas S and Kadanali S: Twin pregnancy with partial hydatidiform mole and coexistent normal fetus. J Obstet Gynaecol. 26:379–380. 2006. View Article : Google Scholar : PubMed/NCBI
15	Shiina H, Oka K, Okane M, et al: Coexisting true hermaphroditism and partial hydatidiform mole developing metastatic gestational trophoblastic tumors. A case report. Virchows Arch. 441:514–518. 2002. View Article : Google Scholar : PubMed/NCBI
16	Sánchez-Ferrer ML, Ferri B, Almansa MT, et al: Partial mole with a diploid fetus: Case study and literature review. Fetal Diagn Ther. 25:354–358. 2009. View Article : Google Scholar : PubMed/NCBI
17	Chu W, Chapman J, Persons DL and Fan F: Twin pregnancy with partial hydatidiform mole and coexistent fetus. Arch Pathol Lab Med. 128:1305–1306. 2004.PubMed/NCBI
18	Navarro Amezcua ME, Castellanos Reyes J, Cardona González O and Torres Gómez LG: Twin pregnancy with partial hydatidiform mole and alive fetus: Case report. Ginecol Obstet Mex. 76:275–279. 2008.(In Spanish). PubMed/NCBI
19	Herek D and Karabulut N: The role of magnetic resonance imaging in the diagnosis of complete hydatidiform mole in a twin pregnancy. Int J Gynaecol Obstet. 123:772013. View Article : Google Scholar : PubMed/NCBI
20	Matsui H, Sekiya S, Hando T, Wake N and Tomoda Y: Hydatidiform mole coexistent with a twin live fetus: A national collaborative study in Japan. Hum Reprod. 15:608–611. 2000. View Article : Google Scholar : PubMed/NCBI
21	Mentula MJ, Niinimäki M, Suhonen S, Hemminki E, Gissler M and Heikinheimo O: Immediate adverse events after second trimester medical termination of pregnancy: Results of a nationwide registry study. Hum Reprod. 26:927–932. 2011. View Article : Google Scholar : PubMed/NCBI
22	Morrison J: Audit of the care of women requesting induced abortion. J Obstet Gynaecol. 23:521–524. 2003. View Article : Google Scholar : PubMed/NCBI
23	Panoskaltsis TA: Mid-trimester termination of pregnancy by dilatation and evacuation. J Obstet Gynaecol. 21:280–284. 2001. View Article : Google Scholar : PubMed/NCBI
24	Kent A: Second trimester termination of pregnancy. Rev Obstet Gynecol. 4:952011.PubMed/NCBI